Many patients, particularly the aged and chronically infirm, experience difficulty with bowel movements owing to various medical problems. Some patients lose control over rectal sphincter muscles so that defecation becomes involuntary, and use of a fecal collection device is required. Others have trouble inducing a bowel movement without use of an artificial stimulus or means such as an enema. In these situations, containment of the fecal matter in collecting and handling it has presented a continuing problem. Conventional bed pans put the patient in an uncomfortable position, frequently requiring untenable maneuvers, and often resulting in unsanitary conditions as well as unpleasant odors. Concern for better containment of and sanitation has become heightened recently in handling of patients with Acquired Immune Deficiency Syndrome (AIDS), whose fecal matter may contain infected blood. The need for improved dilator and collector devices arises not only in common situations, but also in intensive care units, surgery, and settings including nursing homes and geriatric care facilities, and whenever non-ambulatory patients require assistance in this regard.
Various devices for collecting fecal matter have been disclosed in prior patents. U.S. Pat. No. 4,182,332 is directed to a rectal catheter having a stool-collecting bag, the neck of which is secured within the patient's rectum by means of an inserted cannula with outwardly biased flanges which hold the neck against the inner wall of the rectum. In U.S. Pat. No. 3,938,521, a fecal collecting bag is connected to and held in place by an inflatable collar inserted in the rectum. This patent also discloses a channel associated with the bag for application of an enema. U.S. Pat. No. 4,496,356 discloses a collector bag secured to an insertable flexible ring and removable by pulling an elongated flexible member. A collector device using an insertable flexible ring communicating with a collector bag is also shown by U.S. Pat. No. 4,030,500. Another approach as disclosed in U.S. Pat. No. 4,067,335 is to use an insertable funnel connected to an unfolding collector tube, the funnel being held in place by ribs connected by webs that exert pressure on the walls of the anal passage or by being inflated upon insertion. These devices all depend on internally disposed means for holding the collector in place, and the inserted support means of such devices are subject to becoming loosened or disengaged, resulting in extreme contamination.
Desirable features for a dilator/collector device include provision of an external means for holding the collector receptacle in place and an insertable dilator for inducing peristalsis and producing a bowel movement, along with a capability for administering medication and for performing enemas. The collector should, of course, provide for maximum sanitation by reliable containment of fecal matter, with minimum exposure of the patient, nurses, or attendants to contamination. Also, the device should be usable as a transporter to a laboratory for examination or for select disposal, with minimized contamination to the environment.